The CNA Staffing Summit, hosted by The National Association of Health Care Assistants (NAHCA), offered an unfettered look at the career of nursing assistants and the state of our long term care work environments during the COVID-19 pandemic.

The Summit featured several speakers, including David Grabowski, PhD, Professor of Healthcare Policy at Harvard Medical School; Evan Schulman, Director, Division of Nursing Homes CMS; and other experts from the field. The event culminated with a panel of professional nursing assistants presenting their perspective on the important role nursing assistants play in the long term care system.

The event recognized that we need to elevate the career of nursing assistants. Dr. Grabowski shared startling data on the current status of those working in the role, including:

• Long term care work may become the most dangerous profession in the country, as we are on pace to see more than 200 fatalities per 100,000 workers – higher than logging and commercial fishing which previously held that title.
• Long term care organizations nationally still struggle to access PPE and testing for staff.
• National turnover data shows the average turnover rate for NARs is 129%, with some organizations seeing turnover as high as 300%.
• Quality measures improve with higher staffing levels, such as fewer survey deficiencies, pressure ulcers, physical restraints, antipsychotic prescriptions, emergency department visits, and hospitalizations. These measures are threatened as nursing homes across the nation struggle to meet staffing levels for NARs due to COVID-19.

So what can we do to better support caregivers? A panel of seven caregivers shared a list of important concepts:

• Nursing Assistant should be promoted as a career. Remember that for many, the call to be a nursing assistant is a career, not a step on a ladder. Honor both those who see this role as a steppingstone and those who are committed to long term service in the role.
• Nursing Assistants can serve as critical members of the team. Ensure that NARS participate in care conferences, change in condition conversations, quality improvement projects, compliance, hiring, training, and other areas. Trust their competence, expertise, and training.
• Acknowledge hard work. Especially during COVID-19, administrators and executive directors need to acknowledge staff who are working overtime, picking up shifts, or mandated to stay. A genuine face-to-face thank you to those covering open shifts each day is important.
• Teach the WHY. As regulations, waivers, or best practices change, take the time to explain the WHY to caregivers. Knowledge is power and teaching the WHY behind a change empowers caregivers. The panelists felt that trainings were developed for the lowest common denominator, leaving highly skilled caregivers without growth. Teaching at a higher level elevates the team as a whole. One caregiver stated, “We know more than you think we know.”
• Caregivers can be advocates. The more we teach caregivers about reimbursement, regulations, and legislative initiatives, the more caregivers can be an honored and educated voice in our field. One caregiver shared, “Great leaders help caregivers communicate their ideas. We want to be a part of something bigger.”
• Rethink interviews. Interviews often ask questions like, “Do you have transportation?” “What shifts are you available to work?” Although it is important information, it is not inspiring or motivating. Be sure to go beyond those questions in an interview to excite the candidate about a career in long term care.

The final takeaway? The panelists shared, “I want people to take away from this event that being a nursing assistant is a career, it’s not a job. It’s a career. I want administrators to acknowledge, respect, and educate nursing assistants.”